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Megaesophagus in Dogs

Megaesophagus is the most common cause for regurgitation in the dog. Regurgitation results from the inability of the esophagus to contract properly and propagate the food down to the stomach. As a result, the ingested food and/or liquid remains in the esophagus, for anywhere from minutes to hours to days. With the food not reaching the stomach to cause the sensation of being full, the dog will continue to eat. As a result, the esophagus often enlarges as it dilates greatly with food, hence the name of the disease. The majority of cases of canine megaesophagus have no apparent cause, and are therefore given the name, idiopathic megaesophagus. A minority of cases are caused secondary to underyling disease, namely hypothyroidism or mysthenia gravis, and are thus called acquired secondary megaesophagus.

A very rare congenital disease, called a vascular ring anomaly is also possible, but these are usually seen only in very young puppies. The typical age of onset of canine megaesophagus is 7 – 15 years of age according to many sources, but I have not uncommonly seen it in young dogs 1- 5 years of age. I have heard of cases of canine idiopathic megaesophagus in puppies, but have not personally seen any such cases. Clinical signs of megaesophagus will vary depending on severity and may include: regurgitation that may begin minutes to several hours after eating or drinking, excessive salivation, mild to moderate weight loss, coughing, or wheezes. Some affected dogs present with pneumonia, secondary to aspiration of regurgitated contents. This is perhaps the most dangerous consequence of the disease.

The diagnostic work-up for megaesphagus begins with chest x-rays. The x-rays may show the esophagus dilated with food and will determine whether or not there is secondary aspiration pnuemonia. In some cases, the nature of the ingested material does not allow for visualization of a dilated esophagus. If the history fits mega-esophagus, but a dilated esophagus is not seen on routine x-rays, then a contrast study can be performed, where prior to the x-ray, a radio-opaque liquid is swallowed. Since the liquid will show brightly on the x-ray, the integrity and shape of the esophagus will be clearly visualized.

Once it is clearly established that a patient indeed has canine megaesophagus, then the dog must be stablized, and any secondary aspiration pneumonia treated. In addition, it is necessary to differentiate between idiopathic and secondary acquired megaesophagus. A routine profile should be run, constisting of a CBC, chemistry, and urinalysis. In addition, a thyroid profile should be run (TSH, T4, free T4), as well as a test for myesthenia gravis (acetyl choline receptor antibody test).

If the megaesophagus is ultimately acquired secondary, then the primary disease should be treated. Please refer to our Diseases A-Z page provided for more information regarding the treatment of hypothyroidism or myesthenia gravis.

In cases where it is determined that the patient has idiopathic canine megaesophagus, that is, megaesophagus of unknown origin, then husbandry becomes the primary focus in managing the disease. Pro-gastrointestinal motility drugs, such as cisapride and metoclopramide have been used to attempt to incrcease esophageal tone, with little to no success in most cases. I have personally had no success using these drugs to manage the disease.

The main thrust of husbandry management of canine megaesophagus is feeding and watering from elevated dishes. By elevating the food and water, gravity helps to facilitate the passage of food from the esophagus to the stomach. The dishes should be elevated to a height where the dog can just barely reach the bowls, making certain that the dog really has to extend the neck to eat or drink.

In severe cases of canine megaesophagus, even this type of feeding is not enough to prevent chronic regurgitation. For these patients, one can try feeding and watering with dishes placed on top of a step ladder, high enough that the dog has to place the paws on the step ladder in order to reach the food. This serves to orient, not just the neck, but the dog’s entire body in a vertical position to eat and drink from. If the case is so severe that even this does not work, one can obtain special blueprints to construct a special “megaesophagus chair” that the dog can be trained to eat from. I do not have any such blueprints, but clients of mine have found them, among other very helpful tips on a megaesophagus online support group.

Megaesophagus Chair For Dogs

As far as what type of food to feed, dry food is out of the question. A high calorie, high protien canned food (such as a goodcanned puppy food) should be feed in very small amounts frequently throughtout the day. Some patients do better with the food pureed into a liquid, while other do better with the food rolled into small meatballs. Water should also be offered in small amounts frequently. In patients that have trouble with liquid water, you can try offering a crushed ice slush.

The prognosis for canine megaesophagus is guarded, with a great deal depending on severity of disease, the dedication and cooperation of the affected patient’s family, and how effective the dog’s feeding and drinking habits can be regulated and monitored. As stated before, the most dangerous complication of canine megaesophagus is secondary aspiration pneumonia.

 

Roger L. Welton, DVM
Founder and Chief Editor, Web-DVM.net
President, Maybeck Animal Hospital

CEO, Dr. Roger’s Holistic Veterinary Care

Article updated 10/16/2017

35 thoughts on “Megaesophagus in Dogs

  1. Brenda Cloar says:

    I have a little girl that come from shelter at 3 mos. old! Had her checked at our vet and took her home. the next day she was in distress and couldn’t breath. rushed her back the vet. long story short she has megaesophagus. she only weighed 2lbs. and 3 mos old. our vet, like you had never seen a pup with this, so he contacted a friend in Memphis and offered surgery. She was so small and sick I was afraid she wouldn’t make it and I started my own research. She is now 2 1/2 years old and weighs around 5lb and eats in a BAILEY CHAIR. Its been a struggle but she is a little fighter. lots more to this story but wanted to let you know about our little girl that is living with this terrible problem and was born with it.

    • Lindsey says:

      If you could please contact me at lindseyb1983@gmail.com I am experiencing the same issues with my puppy. He is only 3 months old and weighs 2lbs. In need of advice.

      • RLS says:

        Do you know about caninemegaesophagusinfo.com? It’s a great resource for owners. I have a 4 mo. old pup with ME and have found it very helpful.

    • Nancy says:

      My 7yr old 3 lbs Chihuahua was just recently diagnosed with ME my heart is broken is there any tips or suggestions u might have. My only other option is to put her down n I just can’t.

      • Rachael says:

        I have a Chinese crested with ME. She is 11 and was recently diagnosed with that even though she’s had issues most of her life that’s did not know what this was. With a smaller dogs my vet suggested that the dogs or consistency should be that of oatmeal so I put all of my food into a Magic Bullet and puree it. Bully Max weight gainer is another source along with feeding puppy food to maintain weight. Because my dog is a smaller breed I put the food on the side of the tub and she stands on her hind legs and eats that way. Because little are dogs seem to have problems with aspirating food and choking the Bailey Chair was not recommended because they can start choking and flailing around. With the teeny tiny dogs you may want to get a small step stool and put the food on that I use the rubber pot holders to keep it in place so the food doesn’t fall off the surface. Hope this helps

      • Lori says:

        My golden-doodle who is now 4, has had ME since he was a puppy. I use a step ladder for his food giving him puppy food with water as a slurry mix in a Kong bowl. Which slows him down to eat. I also give him about an inch or two of water in a separate bowl also on the step ladder. I give him metoclopramide twice a day. He has had pneumonia three times and each time is treated with an antibiotic which I request an injectable antibiotic. He is about 45 pounds and should be maybe 55. I would not change a thing -he is a happy, well-adjusted dog. He does not know he is sick. He does regurge and that is part of his life as it is mine. I can give him Alpo snaps and he seems to be able to eat them as treats. For hydration in the summer I use gelatin with chicken or vegetable broth I make ice cubes. That is special to him as well !

  2. Amy Pine says:

    My little chiweenie pup was officially diagnosed at 7mos old, but showed great signs of ME at 4 months when we got her. She was regurgitating from day one. The vet said she was born with it. She is now doing really well because we know what to do to keep the food and water down. It’s taken a lot of patience and trial and error. We do have “bad” days every once in a while, but she’s mostly just a fun, spitfire of a pup at almost 2 years old now.

    • Shelly says:

      What do you suggest to keep the food and water down? I got the bailey chair but we are still having difficulty keeping it down .

  3. nayoma Zeese says:

    Isn”t there anythingthat would shrink the esophagus back in place? if not why is surgery so highly impossible?

  4. My husky mix was diagnosed at 1 yr. Also epilepsy. I fed her half ounce meatballs while standing up on a table. It would be too large for a smaller dog but it worked well for her.water was also given elevated. She vomited about 10 to 15 times at least daily but actually learned to be happy until she caught pneumonia– at age 10 1/2 years 2 days ago

  5. Victoria says:

    I have that with my 1 year old dog its so frustrated

  6. jeannie says:

    should i expect good days and bad days

    • Sharon says:

      Hi Jeannie, Yes there are good and bad days. We have a two year old Goldendoodle. She has had ME since the day we brought her home from the breeder. We feed her standing up. She can go days without an episode then, several nights of bad. I have always been amazed how much food she can still has in her stomach after 5 or 6 hours after her last meal. I asked the Vet about that; did not seem to really have a good answer. Enjoy the good days..Good Luck!

  7. Sandy & Kirk says:

    Our German Shepherd had 6 pups Oct 11 of last year. We sold 5 of the little beauties and we kept the 6th. He has been diagnoised with Megaesophagus. I noticed he was breathing quite rapidly when he was about 3 weeks old. His little neck kind of buldged out when he was breathing. Took him to our local vet and she did X-rays and a Barium swallow. He diagnoised him with PRAA. We followed up with a vet surgeon. He did a CT scan and told us Chico has ME and not PRAA. Chico does not regurgitate his food..(well he has only twice in his young life) I now feed him on a chair but will soon have to either purchase a Bailey Chair or find some other way to elevate his feedings. He seems to be doing very well.

  8. Donna Dunne says:

    We have a 4 mo golden doddle, very suspicious of mega esophagus to be confirmed when she is under anesthesia for spaying.she is 18 #,now was 3 @2mo. It has been a challenge we did puppy formula mixed like gruel then graduated to enriched dry on when ever. It seems to happen less when she is kept calm! Work in progress! Bowls elevated!

  9. Elaine says:

    I adopted Milly at 6 mths, diagnosed at 8 mths. Built a rustic Bailey chair and can only feed her twice daily . Ground dry food with water & 30 mins in chair. Now 3 yrs and at ideal weight of 10kg. Some less good days, but she’s happy and healthy.
    Elaine, Tenerife

  10. Brian Uhl says:

    I had to make a feeding bowl for Brodie because he has this same issue. It’s worked very well for him and now I feed all the boys from this bowl. Take a look at it on my web page. Thebrodiebowl.com

    His vet loves it! His lungs have been clear for over 3 years now. Wish everyone the best.

  11. Mike McNeil says:

    I have a 10 month old Mini Schnauzer named Bella. She is a beautiful little puppy that we love with everything we have. My wife and 2 boys and myself understand she was given to us for a reason so we are trying to do all we can to give her a long and happy life. We feed in a high chair and she stays vertical for 15 minutes after each feeding (2 cans of soft puppy food 3 times a day). I can’t remember the last time she ate and threw up with-in 1-2-3 hours after. Our problems start when 1) she gets excited and barks a lot. That makes her choke, then cough then vomit. Needless to say we keep the blinds closed and her away from things that make her bark. 2) maybe 5 out of every 7 nights she will awake to what can only be seen as “heart burn”. She eats dinner between 6-8pm every night and goes to sleep with us around 10-11pm each night. It usually happens between the hours of 2am-5am and you can see its the heart burn that starts the problem, then she coughs, then she throws up but all that comes out is liquid contents from her stomach (and not a lot of that either). Boy, just a tiny bit of this will knock a horse out with its smell so I have to believe its acid from her stomach. Let me also mention that we give her Pepcid AC 1/2 to 3/4 tablet at each feeding (this is at the request of our Vet). I have tried giving her the Pepcid AC after she has the heartburn in the middle of the night but once she starts it doesn’t seem like anything can help her. In any case, does anyone else have this same issue? Her weight is great and she seems health and happy. The sleep loss is not only hurting her but also my wife and I are losing sleep and we each have professional jobs during the weekdays. In any case, ANY help/suggestions would be greatly appreciated!

    • Vivian says:

      Mike,

      Please go to this website. http://www.caninemegaesophagus.org. Also there are two wonderful groups on Facebook, Canine Megaesophagus support group, and Upright Canine Brigade – Megaesophagus Awareness and Support. There is a lot of great information at all 3 sites. The FB pages are filled with a lot of first hand knowledge of what works for people with ME dogs. A lot of vets only know text book information and really don’t know what works, but we live with it on a daily basis and learn what works and what doesn’t through trial and error. The people are as loving and as kind as the fur babies they care for and will help you in more ways than you could imagine.

      • Brenda Cloar says:

        Mine is the first story at the top! I’m Brenda Cloar and I agree with your post. The sites you referred are WONDERFUL I Use FB Upright Canine Brigade! Bella will be 4 yrs in Jan of 2017. Just took her to new vet. He couldn’t believe his eyes when looking at her. X-rays. She is now 6lb 6oz. Good and bad days but she is sweet as pie and HAPPY TO BE ALIVE!! Hang in there fur baby parents of mega-e

    • Steve says:

      Hi, I’m working with my 11.5 year old Great Dane on this.
      I note you said “The contents of her stomach” & it “smells” & her weight is good.
      I don’t think this is ME, as the food stop before the stomach, sits & then regurgitated. The food doesn’t enter the stomach, there for no digestion, no acids, no smell & mine is loosing weight quickly.

      • AnnMarie says:

        I don’t think this is ME either…it would not be bile or vomiting – there is a difference between regurgitating and vomiting. Might want to do some more testing on your pup if you haven’t already. Good luck!

    • Jennifer says:

      Mike, we are having the same issues with our puppy. Were you ever able to get any info/help?

      • Jennifer says:

        My puppy is having the same issues as Mike’s. She was diagnosed through a barium swallow. She is dilated throughout the entire esophagus. She is a 6 month old black lab that weighs 30 #. She has tried multiple medications and is being treated by both her vet and an internal vet also.

  12. Nancy Harrison says:

    Our dog Max got diagnosed with Megaesophogus bout 6 months ago. Our Vet gave him steroids. He seemed to be doing okay we built him a stand so he had to reach for his food. He is off the steroids and is not doing well at all. He is 12 years old and it breaks my heart to see him like this. Not sure what else to do for him.

  13. Laura says:

    My 11 yr old Boxer, Maggie, was diagnosed with ME last couple week. She also has obstruction of the soft palate with laryngeal paralysis, which happened around May 1st. She also pants constantly now. The ME didn’t start right away – that has come about in the last 2 weeks but was diagnosed last week. I have elvated her food, which seemed to keep the last few days, until tonight -it’s been horrible. I hadn’t thought of elevating her water – so I’ve done that. I don’t think she will Be very wiling to do The Bailey Chair. I think I will try putting her food on a chair tomorrow and doing some meatballs and/or purée type food to help. I also rad about making gelatin blox for water to help. Anyone have any other suggestions?

  14. Kathleen Johnson says:

    My 3 and 1/2 year old Rottweiller/black lab mix was diagnosed with Myasthenia Gravis with megasophagus in May…he also has hip displaysia so I use my body as his Bailey chair…he is on pyridostigmine twice daily, metoclopramide three times daily and Prilosec. I cook chicken breast, potato and carrots and blend them…we have been doing ok with bad days every so often, but the last three days have been particularly frustrating. I can’t keep his medication down. Does anyone think a real Baily chair would help and will it hurt his legs? I have been feeling like my home is skilled nursing facility lately. I have his sister, a Chihuahua and a cat. Any advise? Something I’m missing? Thank you.

    • Natalie says:

      I feel your pain, we are in the same situation with our girl, she was diagnosed in July. We’re at our wits end. 1 step forward 4 steps back. Not sure how much longer we can go on like it. We can keep meds down, she’s drinking water like no tomorrow, fed up with continous telling her no.

  15. Lisa says:

    We just lost our precious German Shepherd/Black Lab cross puppy at 6 months old on Sept 30/2016.
    She started by vomiting up her supper and the next morning tipping against the walls while walking, and then started collapsing completely. Took her to the vet,and he thought she had eaten something bad (compost, etc), and gave her a shot of an anti-nausea med. The next morning she was no better. As the day progressed she got to the point where she couldn’t even stand. So we took her to the closest 24 care vet hospital. They did an xray and found nothing remarkable. Temp and all blood work was completely normal. They did a barium swallow that night, and the next morning the barium had barely moved through her esophagus,and they had no idea what was happening. She was started on fluids and antibiotics immediately. The second day there, the vet called a neurologist who said treat for menengitis first, botulism second, and coonhound paralysis third. so she was started on Prednisone immediately. By the third day she was moving her head, fourth day she was turning herself in her kennel and stood on her two right legs. We thought we would soon bring her home. The fifth morning the vet called and said during the night she had taken a turn for the worse. She was regurgitating and they weren’t sure what was happening again. Another call to the neurologist confirmed it was neither botulism nor coonhound paralysis. He said likely either meningitis or myasthenia gravis. So we had another two xrays done. She had mega esophagus and aspiration pneumonia secondary to myasthenia gravis. Neither one treatable in our province.
    Just wondering if anyone else has ever heard of such a quick onset of this that was not congenital. We are completely heartbroken and in shock. She went from chasing tennis balls one day to falling against walls in 18 hours and passed away within a week.

    • Debbie says:

      Our hearts know how you feel, it was like a switch was flipped. Even though our schnauzer mix was 11 years old we walked daily and he played I the yard running like a puppy. I too had thought he had ingested a poison of somesort after vomiting 15 times in 24 hours and not responding to Pepcid or a bland diet and ice chips. I noticed that it wasn’t truly vomit but foam or watery and sometimes food. I read about other dogs with undiagnosed M.E. having an unsatisfiable appetite. The boy could eat and barely keep weight on. We tried feeding him upright with his paws on the back of a recliner and then keeping him upright. It is sincerely heartbreaking because he was used to drinking out of his water bowl which I always kept nice filtered fresh water in. I read about many younger dogs living years with the condition and I sincerely admire their pet parents. Riley after the second drink on the back of the recliner still aspirated and refused to take in any water or food. With heavy hearts he was put to rest this last Saturday. He now can run, play and eat, drink as he likes in heaven. We look back and see subtle hints at this underlying condition, he received quality vetinary care over the years. It may be as with people, asymptomatic. My heart is truly with all pet parents who deal with a chronic medical condition. God bless you and your pet(s),give both of you the strength and knowledge of dealing with them.

  16. Sandi says:

    I have a five week old puppy that was just diagnosed with this. He is part border yorkie. He was born in a liter of 6. We have decided to keep him now because of this, but very scared. He is very playful and healthy. I wonder if because so young will he grow out of this?

    • Sillylily14 says:

      I hope everyones puppy will grow out of this. My puppy has it too and I think she was born with it and it broke my heart. Not 2 years ago I had to put my Lab, Akita, and German shepherd mix to sleep due to old age. I can’t bare to go through that again. I’m hoping she to will grow out of this. She’s only 12 weeks. We decided to go on this journey with her. She’s a very active puppy and happy. I asked my dad what are we going to do? He replied, “we are going to take care of her.” That’s all we can do and that’s what I needed to hear.

  17. Susan Evans says:

    Hi there,
    The special chair Dr. Welton was referring to is the “Bailey Chair.” I was fortunate to be his special needs dog nanny for the last three years of his wonderful life. Donna Koch was his owner and designer of the chair. Please feel free to contact her via her blog which I am attaching and request a free DVD and information packet. I just would to thank you all for caring for special needs dogs.
    Kind Regards,
    Susan

    http://baileychair.blogspot.com/

  18. Rebecca Leyva-Hernandez says:

    I just found out that our puppy has been diagnosed with ME. He is only five weeks and is pure husky. We brought him home 2 nights ago and right away he threw up milk and the dog food we had given him. He was breathing rapidly and heavy but everyone kept telling me it was normal because he is still so young. He did not poop for a day and a half anf when he finally did it was kind of soft. I heard that has nothing to do with it though. But the fact that he wasnt pooping does. We tried feeding him puppy formula mixed with soft puppy food and he ate it but he would still regurgitate. He was also going underneathe the bed a lot and didnt want to play or anything. So we decided to take him to ACCES, a animal emergency center in Colorado. They did an examination. And they also did an Xray. They diagnosed him with ME and also aspiration pneumonia. He is still there as I type this because he is being treated for pneumonia. The vet gave us so much information. But it does take a lot of commitment and dedication on the parents end. The most important thing to know is to keep him/her on his/her hind legs sitting up 20-30 mins after eating and dont let them play around an 1 hour after eating. The food should also be elevated but please give them a low fat diet or they can easily regurgitate again even by smelling the food. Do not give him/her treats or any chew bones! This will cause him/her to regurgitate more. The reason he got aspiration pneumonia is because when he threw up it all didn’t come out which went to his lungs. So the vet said if we see him throw up we should put him upside down so none of it travels back. He has really bad breath but that is associated with ME. Another thing to note is that they not only need a high chair but also its important to have an elevated sleeping station. You can easily make one out of wood so it is in a horizontal “z” shape with his/her bed on top and his/her head on the elevated side. This is very crucial for us especially because my boyfriend works over night and I am a heavy sleeper. But this could help with heart burn and regurgitating. Most dogs with ME should also be eating wet type of foods and should be very regulated. I have read everyone’s comments and I cannot tell you how heartbroken i feel to know that innocent dogs like ours can go through so much… but it is not their fault. Our puppy had it since he was born and we know that only 15% of ME dogs can get rid of it. But we will take that small chance. Good luck to everyone and hang in there… you don’t knoe how much you actually mean to your dog… you are his world and you are so brave.

    Rebecca Leyva-Hernandez

  19. Matt Martin says:

    I just saw four 4 month old Yellow Lab puppies, out of a litter of 8, with this condition at my vets’ office.

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